effect of epidural nalbuphine and morphine versus systemic nalbuphine with epidural morphine in patients submitted for major abdominal surgery

In this double blind randomized study we compared. The effects of epidural nalbuphine to intravenous [IV] nalbuphine on the epidural morphine in patients undergoing elective major abdominal surgery. G[M] [control group] received epidural mixture of bupivacaine 0.5% 1mg/kg and preservative free morphine 150 micro g/ml bupivacaine G[M-epiN] received epidural mixture of bupivacaine 0.5% 1mg/kg and preservative free morphine 150 micro g /ml bupivacaine and preservative and buffer free nalbuphine 30 micro g/mL bupivacaine G[MivN] received epidural mixture of bupivacaine 0.5% 1mg/kg and preservative free morphine 150 micro g/ml bupivacaine and preservative and buffer free nalbuphine 0.1mg/kg [IV] There was no significant changes in analgesia score or sedation score between 3 groups. Nalbuphine markedly adverse the side effects of morphine regarding haemodynamics. There was significant decrease in HR and MAP in the G[M-epiN] G[MivN] groups comparing with G[M]. Our data indicate that the addition of nalbuphine either intra venous or epidurally prevent the morphine induced side effects without reversing its analgesic effect